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Xd the great

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5 minutes ago, Flavio hc16 said:

In other places? Maybe, but in Italy is completely different: we did alone more than double the tests of the rest of Europe combined ( 1 week ago we were at 40k and the rest at 20k now the rest of Europe is at 40k, we are at 90k right now, and I'm counting The UK who did alone 20k tests). Other nations dont release real data ( France and Germany). I wouldn't  believe too much in Chinese numbers either. What I'm  saying is that in Italy  we are at almost 9k infected and 2.5k of assisted pulmonary  ventilators are already being used ( we have like 6-7k in the entire nation)

People who are sick will get tested first. Unless Italy has tested every single person with any COVID19 symptoms at all, the ascertainment rate is not 100%. Not in fact near 100%. The US tests many 100s of thousands positive for flu each year---but the actual number of flu cases is in fact 10s of millions. Most flu patients don't seek care, and are never even diagnosed with flu formally (doc says you have fluwith no test), much less actually tested.

9k confirmed infected means it's probably more like 90k infected, possibly twice that.

Testing is very important, and the earlier the better so those patients can be isolated to prevent spread, but unless the number tested any given week (someone can be negative one week, positive the next) is at least in the 100s of thousands, the ascertainment rate will not be huge since the bulk of COVID19 cases are incredibly mild.

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4 minutes ago, tater said:

People who are sick will get tested first. Unless Italy has tested every single person with any COVID19 symptoms at all, the ascertainment rate is not 100%. Not in fact near 100%. The US tests many 100s of thousands positive for flu each year---but the actual number of flu cases is in fact 10s of millions. Most flu patients don't seek care, and are never even diagnosed with flu formally (doc says you have fluwith no test), much less actually tested.

9k confirmed infected means it's probably more like 90k infected, possibly twice that.

Testing is very important, and the earlier the better so those patients can be isolated to prevent spread, but unless the number tested any given week (someone can be negative one week, positive the next) is at least in the 100s of thousands, the ascertainment rate will not be huge since the bulk of COVID19 cases are incredibly mild.

Nope, this is the difference: in other European  nations they do the test on those who already have symptoms, we don't,  especially where there have been dozens of cases, we had entire villages of 3-5k people who had been all screened, what I'm  saying is  that probably Italy is the best "test subject" for this virus

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16 minutes ago, Flavio hc16 said:

Nope, this is the difference: in other European  nations they do the test on those who already have symptoms, we don't,  especially where there have been dozens of cases, we had entire villages of 3-5k people who had been all screened, what I'm  saying is  that probably Italy is the best "test subject" for this virus

That's great if true, but it needs to be done repeatedly (at least 1 more time for each village withing the timeframe of the illness assuming no one leaves/enters at all).

That the ascertainment rate is under 100% is normal, that 100% rate is virtually never even possible over large groups of people. The problem with conflating the confirmed cases with total is twofold:

1. You grossly underestimate the number of infectious people around.

2. You grossly overstate the risk for any particular person infected.

That doesn't mean it's not 10x (or whatever) worse than flu. That doesn't mean that hospitals already filled with flu patients won't be even more stressed. That doesn't mean that ICU beds become scarce. It just means we don't know the total number of cases, therefore statistics cannot include total cases.

Edited by tater
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58 minutes ago, Flavio hc16 said:

we did alone more than double the tests of the rest of Europe combined ( 1 week ago we were at 40k and the rest at 20k now the rest of Europe is at 40k, we are at 90k right now, and I'm counting The UK who did alone 20k tests). Other nations dont release real data ( France and Germany). I wouldn't  believe too much in Chinese numbers either

Russia, 51 000, South Korea, 140 000, both as of four days ago.

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5 minutes ago, DDE said:

Russia, 51 000, South Korea, 140 000, both as of four days ago.

I did not considered  Russia in.

 

33 minutes ago, tater said:

That's great if true, but it needs to be done repeatedly (at least 1 more time for each village withing the timeframe of the illness assuming no one leaves/enters at all).

That the ascertainment rate is under 100% is normal, that 100% rate is virtually never even possible over large groups of people. The problem with conflating the confirmed cases with total is twofold:

1. You grossly underestimate the number of infectious people around.

2. You grossly overstate the risk for any particular person infected.

That doesn't mean it's not 10x (or whatever) worse than flu. That doesn't mean that hospitals already filled with flu patients won't be even more stressed. That doesn't mean that ICU beds become scarce. It just means we don't know the total number of cases, therefore statistics cannot include total cases.

And on this I completely agree

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3 hours ago, tater said:

The thing that bugs me most however is the coverage. If we covered seasonal flu with the same intensity, people would be terrified of flu. Yes, COVID19 is certainly worse than flu by some multiple, but right now in the US alone, 100 people die every 8 hours from flu.

It seems to be a thing on social media that comparing this to flu = "denier." It's not denial, it's just a constant benchmark we have, and it spreads in a similar way. So if COVID19 runs rampant, we'd expect to see some multiple of the number of flu deaths, and to the extent the deaths are less than or even equal to flu, mitigation has succeeded.

If it's 2X as infectious, and 10X deadlier, if we don't see multiples of flu deaths, either the numbers for R0/mortality are wrong, or mitigation has worked. By a few months into a flu season, we have 10s of millions of cases, and 10s of thousands dead.

The major plus I see to this is awareness of simple hygiene. My kids grew up coughing into their elbows, and washing hands (wife's a surgeon, grandpa's a retired surgeon). They have made fun of people in public bathrooms (to us, not to the faces of the yucky people) not washing hands since they were tiny (as the filthy animals such people are). There's a paper I read a few days ago that suggested that increasing hand washing substantially just in the 20 most busy airports could reduce a pandemic by 66%, no other interventions.

To illustrate the problem posed by this virus, here are some data from Lombary in Italy:

Quote

Deaths from all causes in 2018: 99,542
Daily average: 273
Deaths at 08-03-2020 from Coronavirus only: 133 (135 for 09-03-2020, apparently)

It is a very crude way to calculate, and probably missing a ton of context, but at the moment the number of deaths in Lombardy - from people who got sick a week or two ago - already constitutes around half the daily average number of deaths for all causes. It can of course be assumed that there would have been some overlap between the numbers, so that those who died of Coronavirus would have died of something else around the same time anyway, but the numbers still seem pretty scary.

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Comparing the deaths from the coronavirus to the flu, or ebola, or malaria, or traffic accidents, or whatever is perhaps interesting but not very relevant to a person who actually dies from coronavirus. I'm sure if they could tell you what they felt about it, they would say that it was pretty damn important to them even if it wasn't a major cause of death in the general population.

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For some idea of the scale of testing undertaken in China, the WHO joint mission report on COVID in China noted that:

"By 23 February, there were 10 kits for detection of COVID-19 approved in China by the NMPA, including 6 RT-PCR kits, 1 isothermal amplification kit, 1 virus sequencing product and 2 colloidal gold antibody detection kits. Several other tests are  entered in the emergency approval procedure. Currently, there are at least 6 local producers of PCR test kits approved by NMPA. Overall, producers have the capacity to produce and distribute as many as 1,650,000 tests/week."

While it doesn't say how many people are actually being tested in China, I'd suspect a decent fraction of that 1.6 million kits per week capacity was being utilised, perhaps less so now. It's worth noting that the current tests being used around the world do not have the sensitivity to reliably detect COVID19 in an asymptomatic person, the false negative rate is high until about the time when symptoms also start to show.

For a true idea of how mush asymptomatic transmission occurs, we'll have to wait for widespread serological testing later in the year. However, given the gigantic scale and thoroughness of the contact tracing & quarantine program in China, and the fact that most cases (between 80-100% according to the WHO report) could subsequently be traced back to contact with a person/s who were either symptomatic when contact occurred, or became symptomatic within a day or two, I think the case numbers & percentages seen in China might be close enough to 'real'. If widespread asymptomatic community transmission were occurring I think we'd be seeing more 'random' cases in China still, but most of the ~100 cases reported each day now are apparently occurring either within families in self-isolation, or among people returning from overseas.

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Spoiler

That's how the Permanent Pathogenic Protein eXpress Control System (PPPEXX or P3EX2) has been established on the Earth in early XXI.

Being unable to test significant amount of humans on every infection rush, so being vulnerable to a sudden bioterrorist attack as well, the humanity equipped every door with a biometric sensor detecting any non-human proteins on touch.
On detection it was automatically sending a warning message to the Global Biocontrol Network and an SMS to the hand's owner ("Wash your dirty hands, you lazy pig  you (censored) lazy pig!").
When necessary an additional testing and, if required, isolation was provided by a squad of the Global Bioguards Special Forces.

Later it fruited into the Permanent Planetary Protein Purity (PPPP or P4) initiative, which helped to identify at least ten thousand extraterrestrial visitors disguised as standard humans.

 

Edited by kerbiloid
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32 minutes ago, kerbiloid said:
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Being unable to test significant amount of humans on every infection rush, so being vulnerable to a sudden bioterrorist attack as well, the humanity equipped every door with a biometric sensor detecting any non-human proteins on touch.
On detection it was automatically sending a warning message to the Global Biocontrol Network and an SMS to the hand's owner ("Wash your dirty hands, you lazy pig  you (censored) lazy pig!").
When necessary an additional testing and, if required, isolation was provided by a squad of the Global Bioguards Special Forces.

 

That's eerily close to how it's being done!

This from an Australian journalist staying in an apartment in Beijing - "Up to four guards man the only entry to my compound. They take your temperature each time you walk in and check you're carrying an "entry/exit" pass issued only to residents ... In recent months, temperatures have become like intangible keys. As long as you're below the fever threshold, you can enter compounds, supermarkets and cafes..." .

They're also doing the whole SMS thing - the Alipay cash app sends you a traffic light warning on your phone every day, green is OK, orange for self-isolate now, & presumably red is for anyone infected. Police check your status everywhere you go.

https://www.abc.net.au/news/2020-03-08/coronavirus-quarantine-in-beijing-no-fun-bill-birtles/12032244

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2 hours ago, Listy said:

They're also doing the whole SMS thing - the Alipay cash app sends you a traffic light warning on your phone every day, green is OK, orange for self-isolate now, & presumably red is for anyone infected. Police check your status everywhere you go.

https://www.abc.net.au/news/2020-03-08/coronavirus-quarantine-in-beijing-no-fun-bill-birtles/12032244

The flipside of that pesky social credit system.

Epidemiological credit.

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Ah, international conferences... otherwise known as plague exchange events!

https://www.bostonglobe.com/2020/03/11/nation/how-biogen-leadership-conference-boston-spread-coronavirus/

Quote

It opened with breakfast, at 7 a.m., in the Harbor View Ballroom of the Boston Marriott Long Wharf hotel, where a wide bank of windows offers a sublime view across the inner harbor, steel gray on a cloudy morning, to Logan Airport in the distance.

About 175 executives were expected at the Biogen leadership conference on Feb. 26. Employees from Biogen locations around the United States and the world reunited with colleagues they don’t often get to see.

They greeted each other enthusiastically, with handshakes and hugs, and then caught up over breakfast, picking from plates of pastries and the self-serve hot food bar. They were there for two days of discussions and presentations about the future of the Cambridge-based, multinational biotech firm, which develops therapies for neurological diseases. It was the kind of under-the-radar gathering that happens in this region just about every week.

Within days, though, the Biogen conference would be infamous, identified as an epicenter of the Massachusetts outbreak of Covid-19, with 70 of 92 coronavirus infections in the state linked to the conference as of Tuesday night, including employees and those who came into contact with them. That doesn’t include a cascade of individual cases in Tennessee, North Carolina, Indiana, New Jersey, Washington, D.C., and Norway, and suspected cases in Germany, Austria, and Argentina.

Also,

Also also, Russia's constitutional referendum on April 22 is rather untimely.

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2 hours ago, DDE said:

The flipside of that pesky social credit system.

Epidemiological credit.

Well, that's an advantage of their authoritarian system right here. What they're doing is the way to effectively contain an airborne epidemic. What I've seen out of democratic countries (besides South Korea) is a mix of denial, political jockeying and incompetence. China, at least, had more or less done things right.

3 minutes ago, DDE said:

Ah, international conferences... otherwise known as plague exchange events!

My university literally called off everything that it could the moment multiple cases started being confirmed. Students are to stay home, visitors are prohibited in university-owned housing, everyone who can is supposed to work from home. 

Well, I suppose young PHDs will have to wait for their shot at a tenure just a little while longer... :) 

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2 hours ago, Dragon01 said:

Well, that's an advantage of their authoritarian system right here.

[~ snip ~]

It's about willing to take a hit to your economy, or subject your citizens to disease (and then take a hit to your economy). Contrary to all stereotypes, China, after the first week or so of hesitation, has done their damnedest to save lives.

Edited by Starhawk
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1 hour ago, DDE said:

[~ snip ~]

Or someone who denies there's an epidemic, or that they can get infected. Which, going by some voices from the US, seems to be quite a few. It's not only about being able to agree on implementing quarantine measures, but about having means in place to force citizens into compliance, especially those too dumb to comprehend its necessity. We've had potential patients run away from hospitals over in my country, and I really wish we had a strong enough police force (or deployed the military to help), in order to drag those morons back by their throats.

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Part of the problem is that people have been used to the sort of news coverage we've had for years. "Special Report" with custom graphics, and bespoke theme music, then nothing. They've very effectively trained people to be wary of the news.

What people need is plain information. That Joe Rogan podcast I posed above talks about some issues other than COVID19, but it really is on point on that issue, and he asks the sorts of questions regular people want to know.

We don't have a totalitarian system, so people have to basically be asked to pitch in. Decent humans should work to make this possible. Clearly there are a lot of people who can't simply "stay home," they have work to do, but work in most settings can be made safer via some changes in behavioral norms. Make your elderly family stay away from people if they can, seriously. I'm resolved to the fact that we likely get it as my wife is a healthcare provider—some of her patients can't be bothered to bathe before a long scheduled appt, and will even cough right in her face (people are not very bright out in the world, the subset of people you interact with on a game forum that treats rocket science as a game is NOT the population at large, lol).

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